Pregnancy After Weight Loss Surgery: What You Should Know

Prior to getting pregnant, you and your partner are encouraged to have an appropriate weight or body mass index (BMI). Because people who have a high BMI are at risk of many pregnancy complications, starting pregnancy at a healthy weight or at least reducing your BMI is one of the best ways to ensure you and your baby have the healthiest start possible.

However, losing weight is not simple, and many people find conventional dieting does not work for them. These issues have given rise to the weight loss surgery techniques of today, also known as bariatric surgeries. Weight loss surgery and subsequent weight loss can increase fertility rates.

While bariatric surgery is a way to lose weight, it does pose risks to the health of the individual, if not carefully managed. If you have had bariatric surgery and now want to get pregnant, you may wonder whether there are any precautions you need to take. The general recommendation is to avoid pregnancy for at least two years after weight loss surgery, though this belief is not shared by all practitioners and researchers. Here are other things to keep in mind.

Benefits of weight loss surgery prior to pregnancy

There are a number of studies that show benefits of having weight loss surgery prior to pregnancy. Remember, the goal of the surgery is to reduce the risk of complications both to the mother and to the baby. One major study found that there was a reduction in the number of cases of gestational diabetes and excessive fetal growth.

Potential risks of pregnancy after weight loss surgery

There are risks associated with pregnancy after weight loss surgery. This can include a shorter gestational age and a small-for-gestational-age baby, meaning your baby weighs a lot less than their peers. However, this risk can be reduced by waiting at least two years post-surgery to get pregnant. One study showed that the risks of having a stillbirth or neonatal death were very slightly increased, but this finding was considered to be on the borderline for significance.

There may also be a higher risk of surgical complications in pregnancy, meaning that you have complications related to the weight loss surgery while you are pregnant. These can include abdominal adhesions, an obstruction in your bowel, or even a hernia. These are normal complications of surgeries, but they may be exacerbated by the expanding abdomen during pregnancy.

Special testing in pregnancy

Because it is more common for people to experience micronutrient deficiencies after weight loss surgery, this needs to be carefully watched in pregnancy. It is recommended that you get laboratory testing both before and during pregnancy. While specific testing usually isn’t done until there is a diagnosis of anemia, all women who have had weight loss surgery should be tested. You should at least be tested for iron, folate, vitamin B12, vitamin D, and thiamine, though other studies point to the potential for deficiencies involving other micronutrients.

Supplements in pregnancy

Supplementation is one way to begin to address any micronutrient deficiencies found during pregnancy, but it’s only partially effective. The real key is to find someone who has experience working with your nutritional needs after bariatric surgery, who can help your doctor or midwife order appropriate tests and guide you in getting enough protein and micronutrients to help you and your baby stay healthy.

Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of Childbirth.org, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram, and Facebook.